Provider Demographics
NPI:1760653976
Name:YOAKUM COUNTY MEDICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:YOAKUM COUNTY MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-384-6238
Mailing Address - Street 1:PO BOX 2023
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76202-2023
Mailing Address - Country:US
Mailing Address - Phone:940-384-6238
Mailing Address - Fax:
Practice Address - Street 1:412 MUSTANG DR
Practice Address - Street 2:
Practice Address - City:DENVER CITY
Practice Address - State:TX
Practice Address - Zip Code:79323-2750
Practice Address - Country:US
Practice Address - Phone:806-592-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z494Medicare PIN